Effects of Danhong Injection (丹红注射液) on Peri-Procedural Myocardial Injury and Microcirculatory Resistance in Patients with Unstable Angina Undergoing Elective Percutaneous Coronary Intervention: A Pilot Randomized Study<sup>*</sup>

Wen-long XING; Yong-jian WU; Hong-xu LIU; Qing-rong LIU; Qi ZHOU; Ai-yong LI; Zhu-hua ZHANG; Xuan LI

doi:10.1007/s11655-021-2872-1

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Effects of Danhong Injection (丹红注射液) on Peri-Procedural Myocardial Injury and Microcirculatory Resistance in Patients with Unstable Angina Undergoing Elective Percutaneous Coronary Intervention: A Pilot Randomized Study^*

Clinical Experience | Updated：2021-11-05

- Effects of Danhong Injection (丹红注射液) on Peri-Procedural Myocardial Injury and Microcirculatory Resistance in Patients with Unstable Angina Undergoing Elective Percutaneous Coronary Intervention: A Pilot Randomized Study^*
- Chinese Journal of Integrative Medicine Vol. 27, Issue 11, Pages: 846-853(2021)
- Affiliations：
  
  1.Department of Cardiology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing (100010), China
  2.Department of Cardiology, Fuwai Hospital, Beijing(100037), China
- Author bio：
  
  Prof. LIU Hong-xu, E-mail: lhx_@263.net
- Funds：
- DOI：10.1007/s11655-021-2872-1
  CLC：
- Published：01 November 2021，
  
  Published Online：14 July 2021，
  
  Accepted：25 September 2020
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Wen-long XING, Yong-jian WU, Hong-xu LIU, et al. Effects of Danhong Injection (丹红注射液) on Peri-Procedural Myocardial Injury and Microcirculatory Resistance in Patients with Unstable Angina Undergoing Elective Percutaneous Coronary Intervention: A Pilot Randomized Study^*. [J]. Chinese Journal of Integrative Medicine 27(11):846-853(2021)
DOI：

Wen-long XING, Yong-jian WU, Hong-xu LIU, et al. Effects of Danhong Injection (丹红注射液) on Peri-Procedural Myocardial Injury and Microcirculatory Resistance in Patients with Unstable Angina Undergoing Elective Percutaneous Coronary Intervention: A Pilot Randomized Study^*. [J]. Chinese Journal of Integrative Medicine 27(11):846-853(2021) DOI： 10.1007/s11655-021-2872-1.

摘要

目的:

评价丹红注射液对不稳定型心绞痛择期经皮冠状动脉介入治疗 (PCI) 患者围手术期心肌损伤及冠脉微循环阻力的影响.

方法:

78例不稳定型心绞痛择期PCI患者随机分为丹红组 (DH

39例) 和对照组 (39例) . 采用随机数字表法进行分组

DH组在PCI期间给予DH 40ml (混合生理盐水250ml

用避光袋遮挡

静脉滴注)

术后继予每日1次

连续7天; 对照组用同样方法予等量生理盐水. 两组均接受规范化治疗

在PCI术前、后测定患者冠脉微循环阻力指数 (IMR) 和血流储备分数 (FFR) . 患者术前及术后24小时检测心肌标志物

包括肌红蛋白、肌酸激酶 (CK) 、肌酸激酶MB (CK-MB) 和肌钙蛋白T (cTnT) .

结果:

入选的78例患者中

两组的基线资料和介入操作特点无差异. 两组PCI术前心肌损伤标志物及冠脉生理学指标均无统计学差异

DH组PCI术后CK、CK-MB水平低于对照组并具有统计学差异 (111.97±80.97vs.165.47±102.99

P=0.013; 13.08±6.90vs.19.75±15.49

P=0.016) . DH组PCI术后肌红蛋白和cTNT阳性率低于对照组

但无统计学差异 (88.07±52.36vs.108.13±90.94

P=0.52; 2.56% vs.7.69%

P=0.065) . 与对照组相比

DH组IMR后水平有下降趋势

但无统计学差异 (20.73±13.15 vs.26.37±12.31

P=0.05) . 术后FFR两者无统计学差异. DH组PCI围手术期心肌损伤发生率低于对照组

具有统计学差异 (2.56% vs.15.38%

P=0.025) . 在术后30天的随访期间

两组均未发生MACEs事件.

结论:

DH对减轻不稳定型心绞痛择期PCI患者围手术期心肌损伤及改善微血管功能具有一定作用.

Abstract

Objective:

To evaluate the effect of Danhong Injection (丹红注射液

DH) on the index of microcirculatory resistance (IMR) and myocardial injury in patients with unstable angina undergoing elective percutaneous coronary intervention (PCI).

Methods:

Seventy-eight patients with unstable angina were randomly divided into DH group (39 cases) and the control group (39 cases) during elective PCI. Randomization was performed using a random-number table. The DH group received DH at a dosage of 40 mL (mixed with 250 mL saline

covered by a light-proof bag

intravenous drip) during PCI and daily for 7 consecutive days

while the control group only received the same dosage of saline. Both groups received standardized treatment. The IMR and fractional flow reserve (FFR) were measured at maximal hyperemia before and after PCI. Myocardial markers

including myoglobin

creatine kinase (CK)

creatine kinase MB (CK-MB)

and coronary troponin T (cTnT) values were measured at baseline and 24 h after PCI.

Results:

Among the 78 patients enrolled

the baseline and procedural characteristics were similar between the two groups. There was no significant difference in pre-PCI myocardial markers and coronary physiological indexes between the two groups. However

post-PCI CK and CK-MB levels in the DH group were significantly lower than those in the control group (111.97±80.97 vs. 165.47±102.99

=0.013; 13.08±6.90 vs. 19.75±15.49

=0.016). Post-PCI myoglobin and cTNT-positive tend to be lower in the DH group than in the control group but did not reach statistical significance (88.07±52.36 vs. 108.13±90.94

=0.52; 2.56% vs.7.69%

=0.065). Compared with the control group

the post-IMR levels of the DH group tended to decrease

but there was no statistical difference (20.73±13.15 vs. 26.37±12.31

=0.05). There were no statistical differences in post-FFR in both groups. The peri-procedural myocardial injury of the DH group was significantly lower than that of the control group (2.56% vs. 15.38%

=0.025). During the 30-d follow-up period

no major adverse cardiovascular events occurred in either group.

Conclusion:

This study demonstrated benefit of DH in reducing myocardial injury and potential preserving microvascular function in patients with unstable angina undergoing elective PCI.

关键词

Keywords

peri-procedural myocardial injurypercutaneous coronary interventionmicrocirculatory resistancemicrovascular dysfunction

references

Thygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA, et al. Fourth Universal Definition of Myocardial Infarction 2018. Eur Heart J. 2018. https://doi.org/10.1093/eurheartj/ehy462https://doi.org/10.1093/eurheartj/ehy462. Accessed 30 Sep 2018.

Cho MS, Ahn JM, Lee CH, Kang DY, Lee JB, Lee PH, et al.Differential ratesand clinical significance of periprocedural myocardial infarction after stenting or bypass surgery for multivessel coronary disease according to various definitions. JACC Cardiovasc Interv 2017;10:1498-1507.

Heusch G, Skyschally A, Kleinbongard P. Coronary microembolization and microvascular dysfunction. Intl J Cardiol2018:S0167527317378361.

De Bruyne B, Oldroyd KG, Pijls NHJ. Microvascular (Dys) function and clinical outcome in stable coronary disease. J Am Coll Cardiol 2016;67:1170-1172.

Fearon WF, Balsam LB, Farouque HM, Caffarelli AD, Robbins RC, Fitzgerald PJ, et al. Novel index for invasively assessing the coronary microcirculation. Circulation 2003;107:3129-3132.

Lee MJ, Park SD, Kwon SW, Woo SI, Lee MD, Shin SH, et al. Relation between neutrophil-to-lymphocyte ratio and index of microcirculatory resistance in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Am J Cardiol 2016;118:1323-1328.

Li SN, Li P, Liu WH, Shang JJ, Qiu SL, Zhou MX, et al.GW29-e0502 Danhong Injection enhances angiogenesis after myocardial infarction by activating MiR-126/ERK/VEGF pathway.Biomed Pharmacother 2019;120:109538.

Jneid H, Anderson JL, Wright RS, Adams CD, Bridges CR, Casey DE, et al. 2012 ACCF/AHA focused update of the guideline for the management of patients with unstable angina/Non-ST-elevation myocardial infarction (updating the 2007 guideline and replacing the 2011 focused update): A Report of the American College of Cardiology. J Am Coll Cardiol 2012;60:645-681.

Zheng XY. Guiding principle of clinical research on new drugs of traditional Chinese medicine. Beijing: China Medical Pharmaceutical Sciences and Technology Publishing House; 2002:68-73.

Lee DW, Cavender MA. Periprocedural myocardial infarction in contemporary practice. Interventional Cardiol Clin 2019;8:209-223.

Clearfield M. Efficacy of atorvastatin reload in patients on chronic statin therapy undergoing percutaneous coronary intervention. J Am Coll Cardiol 2009;54:558-565.

Patti G, Colonna G, Pasceri V, Pepe LL, Montinaro A, Di Sciascio G. Randomized trial of high loading dose of clopidogrel for reduction of periprocedural myocardial infarction in patients undergoing coronary intervention: results from the ARMYDA-2 (Antiplatelet therapy for reduction of myocardial damage during angioplasty) study.Circulation 2005;111:2099-2106.

Pelliccia F, Pasceri V, Granatelli A, Pristipino C, Speciale G, Roncella A, et al. Safety and efficacy of short-term celecoxib before elective percutaneous coronary intervention for stable angina pectoris. Am J Cardiol 2006;98:1461-1463.

Li SM, Li JG, Xu H. A new perspective for Chinese medicine intervention for coronary artery disease: targeting inflammation.Chin J Integr Med 2019;25:3-8.

Jiang Y, Lian YJ. Effects of Danhong Injection on hemodynamics and the inflammation-related NF-κB signaling pathway in patients with acute cerebral infarction. Genet Mol Res 2015;14:16929-16937.

Duan ZZ, Li YH, Li YY, Fan GW, Chang YX, Yu B, et al. Danhong Injection protects cardiomyocytes against hypoxia/reoxygenation-and H2O2-induced injury by inhibiting mitochondrial permeability transition pore opening. J Ethnopharmacol 2015;175:617-625.

Gao LN, Cui YL, Wang QS, Wang SX. Amelioration of Danhong Injection on the lipopolysaccharide-stimulated systemic acute inflammatory reaction via multi-target strategy. J Ethnopharmacol 2013;149:772-782.

He S, Zhao T, Guo H, Meng Y, Qin G, Goukassian DA, et al.Coordinated activation of VEGF/VEGFR-2 and PPARδ pathways by a multi-component Chinese medicine DHI accelerated recovery from peripheral arterial disease in type 2 diabetic mice. Plos One 2016;11:e0167305.

Zhang YY, Zhou HF, Yang JH, He Y, Chen XQ, Nishinari K, et al. Effects of Danhong Injection (and its main components on anticoagulation and fibrinolysis in cultured vein endothelial cells.Chin J Integr Med 2016;22:276-283.

Zhang X, Wang H, Chang Y, Wang Y, Lei X, Fu S, et al. An overview of meta-analyses of Danhong Injection for unstable angina. Evid Based Complement Altern Med 2015;2015:1-8.

Xie X, Zhang DW, Liu HX, Dong J, Chen YD. Protective effects of Danhong Injection on perioperative myocardial injury in patients with unstable angina pectoris and blood stasis syndrome during selective percutaneous coronary intervention. Chin J Integr Med Cardio-/Cerebrovasc Dis (Chin) 2016;11:1185-1188.

You Q, Wang J, Dong W, Tian F, Liu HX, Jing J, et al. Protective effect of Danhong injection in patients with acute myocardial infarction at a high risk of no-reflow during primary percutaneous coronary intervention. J Geriatric Cardiol 2019;16:406-413.

Liu HX. Consensus of traditional Chinese medicine specialists on percutaneous coronary intervention perioperative myocardial injury.World Chin Med 2016;11:377-380.

Saucedo JF, Mehran R, Dangas G, Hong MK, Lansky A, Kent KM, et al. Long-term clinical events following creatine kinase—myocardial band isoenzyme elevation after successful coronary stenting. J Am Coll Cardiol 2000;35:1134-1141.

Wu Z, Ye F, You W, Zhang J, Xie D, Chen S. Microcirculatory significance of periprocedural myocardial necrosis after percutaneous coronary intervention assessed by the index of microcirculatory resistance. Int J Cardiovasc Imag 2014;30:995-1002.

Mangiacapra F, Bressi E, Di Gioia G, Pellicano M, Di Serafino L, Peace AJ, et al. Coronary microcirculation and peri-procedural myocardial injury during elective percutaneous coronary intervention. Int J Cardiol https://doi.org/10.1016/j.ijcard.2019.12.042https://doi.org/10.1016/j.ijcard.2019.12.042.

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Key Discipline of Integrated Traditional Chinese and Western Medicine, Second Clinical College, Guangzhou University of Chinese Medicine

Department of Critical Care Medicine, Guangdong Provincial Hospital of Chinese Medicine

Doctoral Candidate of Guanzhou University of Chinese Medicine

Department of Cardiovascular Disease, Huashan Hospital, Fudan University

Department of Biostatistics, School of Public Health, Fudan University

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